Hemoflagellates Flashcards by VERNARD DOMINIC ALOYON

Flagellates that are found in the blood and other fluids (CSF) and in tissues

Hemoflagellates

How well did you know this?

Not at all

Perfectly

They are vector-borne parasites

Hemoflagellates

How well did you know this?

Not at all

Perfectly

Hemoflagellates

Another important note, they are transmitted by the bite of the ______.

arthopod

How well did you know this?

Not at all

Perfectly

Hemoflagellates

Medically Important Genera

● Trypanosoma
● Leishmania

How well did you know this?

Not at all

Perfectly

Generalities

Only Trypanosoma and Leishmania infect ________

humans

How well did you know this?

Not at all

Perfectly

Generalities

There are four morphological forms encountered in the life cycle of Hemoflagellates:

■ Amastigote
■ Promastigote
■ Epimastigote
■ Trypomastigote

How well did you know this?

Not at all

Perfectly

Generalities

What would be the basis of differentiating the four morphologic forms?

location of the nucleus.
location of the kinetoplast

How well did you know this?

Not at all

Perfectly

Generalities

the energizing structure of the parasite

kinetoplast

How well did you know this?

Not at all

Perfectly

four morphological forms

Amastigote is also know as

Donovan Leishman Body

How well did you know this?

Not at all

Perfectly

four morphological forms

This would appear as a round to oval structure

Amastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

Aside from being round to oval in shape, the amastigote would have no _______

flagella

How well did you know this?

Not at all

Perfectly

four morphological forms

Another feature of the parasite, this would be found inside the cell, an intracellular form

Amastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

The kinetoplast is adjacent or near your basal body.

Amastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

Also known as

Promastigote

Leptomonas Stage

How well did you know this?

Not at all

Perfectly

four morphological forms

long and slender, and it would
already have a flagella, in the anterior part.

Promastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

The nucleus will be found in the center of the parasite

Promastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

kinetooplast is found
anterior (nasa harap) to your nucleus

Promastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

also known as

Epimastigote

Crithidia Stage

How well did you know this?

Not at all

Perfectly

four morphological forms

Nucleus is more posterior when compared to the promastigote

Epimastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

kinteoplast is found anterior to the nucleus. But the kinetoplast is more adjacent to the nucleus

Epimastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

presence
of the undulating membrane (one half (1/2) the body length)

Epimastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

helping in the
motility of the parasite.

undulating
membrane

How well did you know this?

Not at all

Perfectly

four morphological forms

It is also long or elongated, but if you would notice, the shape would look like S, C, or U shaped

Trypomastigote

How well did you know this?

Not at all

Perfectly

four morphological forms

the location of the nucleus, would be found more anterior than the kinetoplast

Trypomastigote

How well did you know this?

Not at all

Perfectly

# four morphological forms undulating membrane is also found here, but is now full body length

Trypomastigote

# four morphological forms Another unique feature would be the granules found in your trypomastigote, called the | Trypomastigote

volutin granules

# Other Present Generalities: Life Cycle All forms are found in __________ infections

Trypanosoma cruzi

# Other Present Generalities: Life Cycle Only the _________ and _______ are seen in Tryanosoma brucei infections

epimastigote and trypomastigote

# Other Present Generalities: Life Cycle seen in the insect vector of Trypanosoma brucei

Epimastigote

# Other Present Generalities: Life Cycle found in the humans in Tryanosoma brucei infections.

trypomastigote

# Other Present Generalities: Life Cycle Only the _________ and ___________ are seen in Leishmania infections

amastigote and promastigote

# Other Present Generalities: Life Cycle seen in the insect vector of Leishmania

Promastigote

# Other Present Generalities: Life Cycle will be found in humans in Leishmania infections

amastigote

# Other Present Generalities: Life Cycle Diagnostic Stages (found in humans) include:

- amastigote - trypomastigote

# Other Present Generalities: Life Cycle For Trypanosoma cruzi and Trypanosoma brucei, the infective stage of these two would be the __________.

metacyclic trypomastigote

# Other Present Generalities: Life Cycle On the other hand, for the members of Leishmania, the infective stage would be the _________.

promastigote

# Other Present Generalities: Life Cycle Final host

humans

# Other Present Generalities: Life Cycle intermediate host

insect vector

# Trypanosoma cruzi Belongs to Trypanosome Group:

Stercoraria

# Trypanosoma cruzi Primarily Infects:

Myocytes and cells of RESs

# Trypanosoma cruzi RES meaning

reticulo-endothelial system

# Trypanosoma cruzi reticulo-endothelial system:

- spleen - lymph node - immune cells

# Trypanosoma cruzi causes

Chagas’ Disease or American Trypanosomiasis

# Trypanosoma cruzi Majority of cases are found in

South America (Brazil)

# Trypanosoma cruzi: Life Cycle Triatomine Bug other names: | Triatomine Bug to Human transmission

Kissing Bug, Reduviid Bug, and Assassin Bug

# Trypanosoma cruzi: Life Cycle Usually the ____ triatomine bug bites humans to take a blood meal | Triatomine Bug to Human transmission

female

# Trypanosoma cruzi: Life Cycle Usually occurs during the ____ | Triatomine Bug to Human transmission

night

# Trypanosoma cruzi: Life Cycle Prefer biting near the _________ | Triatomine Bug to Human transmission

mucosal membrane

# Trypanosoma cruzi: Life Cycle After the triatomine bug is full from feeding on the blood, it will ______ | Triatomine Bug to Human transmission

defecate

# Trypanosoma cruzi: Life Cycle Infective stage of the parasite is found in the _____ of the kissing bug | Triatomine Bug to Human transmission

feces

# Trypanosoma cruzi: Life Cycle __________ will penetrate cells at the bite site and will transform into amastigotes | Human Stages

Metacyclic trypomastigotes

# Trypanosoma cruzi: Life Cycle Amastigotes multiply by ________ | Human Stages

binary fission

# Trypanosoma cruzi: Life Cycle Some amastigotes will be released and will transform into _________ (found extracellularly); some are released in the ______ | Human Stages

- trypomastigotes - blood

# Trypanosoma cruzi: Life Cycle Repeating cycle inside the body: | Human Stages

1. Amastigotes multiply 2. Intracellular amastigotes transform into trypomastigotes, then burst out of the cell and enter the blood stream (Diagnostic Stage) 3. Trypomastigotes can infect other cells and transform into intracellular amastigotes in new infection sites

# Trypanosoma cruzi: Life Cycle Another kissing bug will bite the infected person and will get the ______ | Triatomine Bug Stages

trypomastigote

# Trypanosoma cruzi: Life Cycle Once ingested, it transforms into an _______ in the midgut or GI track | Triatomine Bug Stages

epimastigote

# Trypanosoma cruzi: Life Cycle Epimastigote will multiply by _________ | Triatomine Bug Stages

asexual reproduction

# Trypanosoma cruzi: Life Cycle Eventually, this epimastigote will become a _________ found in the hindgut | Triatomine Bug Stages

metacyclic trypomastigote

# Trypanosoma cruzi: Life Cycle is found on the posterior part of the kissing bug | Triatomine Bug Stages

Hindgut

# Trypanosoma cruzi: Life Cycle It would then be released in the ________ after the blood meal of the kissing bug | Triatomine Bug Stages

feces

# Trypanosoma cruzi: Life Cycle Final host

humans

# Trypanosoma cruzi: Life Cycle Intermediate host vector

Reduviid bug/ kissing bug | (Triatoma, Panstronglylus, Rhodnius)

# Trypanosoma cruzi: Life Cycle MOT

- Feces of vector entering bite wound - blood transfusion - organ transplants - transplacentally

# Trypanosoma cruzi: Life Cycle Unknowingly, organs transplanted may have ________ that will multiply and release trypomastigote which will start the life cycle on the person

amastigotes

# Trypanosoma cruzi: Life Cycle Infective stage to humans

Metacyclic trypomastigote

# Trypanosoma cruzi: Life Cycle Diagnostic stage

- trypomastigote (found in the blood) - amastigote (inside the cells and tissue)

# Trypanosoma cruzi: Life Cycle Amastigotes inside tissues in the _____ phase of the illness

chronic

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Acute Phase

- fever and lymphadenopathy - diffuse inflammation - malaise - nausea - vomiting

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis local inflammation; reddish nodule; central edema, regions; lymphadenopathy | Acute Phase

Chagoma

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis periorbital swelling (edema of eyelid and conjunctiva); periorbital swelling (swelling is usually on one side) | Acute Phase

Romana’s sign

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis After the acute stage is the ________, wherein all of the symptoms and manifestation seen will eventually disappear but the parasite is still present.

latent stage

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis no characteristic symptoms

Chronic Phase

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis 20 years or more, the patient will proceed to the chronic phase, wherein there is an ________ of different vital organs due to the multiplying amastigotes found inside the different tissues | Chronic Phase

enlargement

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Manifestations of Chronic Phase

■ Mega esophagus, mega colon, cardiomegaly, cardiac arrhythmia ■ Can lead to death; very common cause of death is heart problems ■ In South America, a common cause of cardiac arrhythmia and abnormal ECG results would be the T. cruzi

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Direct inflammatory response: | Pathogenesis

■ Chaga-toxin ■ Damage to infected cells ■ Destruction of autonomic nerve ganglions

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Uses ____ like carbohydrates for binding | Pathogenesis

lectin

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Acute _______ reaction on bite | Pathogenesis

inflammatory

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Target cells: | Pathogenesis

- cells of RES - cardiac cells - skeletal and smooth muscles - neuroglia cells

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Trypanosoma cruzi: Diagnosis

● Presence of Lesions ● Cardiac symptoms a ● Presence of Trypomastigote (Acute phase) ● Demonstration of trypanosomes

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Demonstration of trypanosomes in blood

thick and thin smears

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Demonstration of trypanosomes in buffy coat

concentration technique (Strout Method)

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Demonstration of trypanosomes in CSF, tissues

Tissue and biopsy samples | You will find amastigotes (chronic stage)

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Demonstration of trypanosomes in:

- blood - Buffy coat layer - CSF, tissues - lymph

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Involves a suspected patient

Xenodiagnosis

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Culture:

■ Chang’s ■ NNN (Novy MacNeal Nicolle)

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Serology

- IFAT - Complement Fixation - ELISA - Western Blot

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis IFAT meaning

Immunofluorescence Antibody Test

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis detection of complement fixing antibodies.

Complement Fixation

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis ELISA meaning

Enzyme-linked immunoassay

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis Complement fixation test used in T.cruzi

Guerreiro Machado Test

# Trypanosoma cruzi: Epidemiology Occurs only in the ______ continent

American

# Trypanosoma cruzi: Epidemiology Highest prevalence in

Brazil

# Trypanosoma cruzi: Epidemiology More common in _____ areas

rural

# Trypanosoma cruzi: Epidemiology _________ disease is more common

Chronic

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis A kissing bug is placed on the skin of the patient, covered in a _________, for the bug to bite the skin | Xenodiagnosis

copper container

# Trypanosoma cruzi: Disease Manifestation and Pathogenesis If a parasite develops in the kissing bug after a few months, a patient is positive for the infection

Xenodiagnosis

# Trypanosoma cruzi: Epidemiology Common in _______ housing conditions

unsanitary

Another cause of American Trypanosomiasis

Trypanosoma rangeli

Trypanosoma cruzi: Treatment

Nifurtimox and Benznidazole

# Trypanosoma rangeli Vector

Rhodnius

# Trypanosoma brucei complex Etiologic Agents of African Sleeping Sickness

- Trypanosoma brucei rhodesiense - Trypanosoma brucei gambiense

# Etiologic Agents of African Sleeping Sickness Causes Rhodesian or East African Sleeping Sickness

Trypanosoma brucei rhodesiense

# Etiologic Agents of African Sleeping Sickness Endemic (local transmission) in East and South Africa

Trypanosoma brucei rhodesiense

# Etiologic Agents of African Sleeping Sickness is more acute; rapidly progressing; patient is usually in the sleeping phase in less than 9 months

Trypanosoma brucei rhodesiense

# Etiologic Agents of African Sleeping Sickness Causes Gambian or West African Sleeping Sickness

Trypanosoma brucei gambiense

# Etiologic Agents of African Sleeping Sickness is more chronic; longer progression; more common and prevalent

Trypanosoma brucei gambiense

# Etiologic Agents of African Sleeping Sickness primarily affects wild and domestic animals; current research shows that it does not cause disease/s in humans

T. brucei brucei

# Vector Transmitted Parasitic Infections T. brucei Vector of T. Brucei

Tsetse Fly (Glossina spp.)

# Vector Transmitted Parasitic Infections T. brucei T. b. rhodesiense Glossina spp

- G. pallidipes - G. morsitans

# Trypanosoma rangeli Difference: Metacyclic Trypomastigote is discharged via the _________

salivary glands

# Trypanosoma rangeli Is Trypanosoma rangeli pathogenic?

# Vector Transmitted Parasitic Infections T. brucei T. b. gambiens Glossina spp

G. palparis

# Vector Transmitted Parasitic Infections T. brucei Infective stage to humans

Metacyclic Trypomastigote

# T. brucei: Life Cycle Humans get the infection when they are bitten by the Tsetse Fly. The fly takes a blood meal while simultaneously injecting __________

metacyclic trypomastigotes

# T. brucei: Life Cycle The injected metacyclic trypomastigote becomes a _________, which will be distributed to other sites of the body

trypomastigote

# T. brucei: Life Cycle The procyclic trypomastigote will then become an _________.

epimastigote

# T. brucei: Life Cycle The epimastigotes then travel to the salivary glands to multiply and to eventually become _____________.

metacyclic trypomastigotes

# T. brucei: Life Cycle Infective stage to humans

metacyclic trypomastigotes

# T. brucei: Life Cycle Diagnostic stage

presence of trypomastigote

# T. brucei: Life Cycle What form is found in the insect

Epimastigote

# T. brucei: Life Cycle What form is in the mammalian host

Trypomastigote

# T. brucei: Life Cycle Usually if trypomastigote is found in the blood, it’s _________ stage of the illness

acute or early

# T. brucei: Life Cycle In order for the life cycle to continue, another Tsetse fly will bite the infected patient. The fly would then get the _________

trypomastigote

# T. brucei: Life Cycle The ________ will multiply by binary fission and can be found in different body fluids such as the blood, lymph/lymph nodes, and spinal fluid/CSF.

trypomastigotes

# T. brucei: Life Cycle Inside the G.I. Tract of the Tsetse fly, the trypomastigote will become __________, wherein these will also undergo binary fission to multiply

procyclic trypomastigotes

# Disease Manifestation: T.brucei painful ulceration Sickness | Gambian or West African Sleeping

Trypanosomal Chancre

# Disease Manifestation: T.brucei Earliest sign : Sickness | Gambian or West African Sleeping

Trypanosomal Chancre

# Disease Manifestation: T.brucei Patients still appear ______ | Trypanosomal Chancre

healthy

# Disease Manifestation: T.brucei Blood smear : | Trypanosomal Chancre

(+) Trypomastigotes

# Disease Manifestation: T.brucei It can last for weeks or months, the parasite would eventually affect the _________ | Trypanosomal Chancre

central nervous system

# Disease Manifestation: T.brucei Patients experience fever once the _______ are affected. Other manifestations include malaise, weakness, night sweats, dizziness, and nausea. | Trypanosomal Chancre

lymph nodes

# Disease Manifestation: T.brucei Occurs when there is enlargement of cervical lymph node | Gambian or West African Sleeping

Winterbottom’s sign

# Disease Manifestation: T.brucei cervical lymph node size | Winterbottom’s sign

“Ripe plum”

# Disease Manifestation: T.brucei Can find the trypomastigotes in the _______ | Winterbottom’s sign

lymph or lymphatic fluid

# Disease Manifestation: T.brucei Chronic Disease | Gambian or West African Sleeping

■ CNS invasion ■ Sleeping sickness stage initiated ■ Terminal Phase

# Disease Manifestation: T.brucei Chronic Disease Signs and symptoms: | Gambian or West African Sleeping

- severe headache - increasing mental deterioration and apathy - meningoencephalitis

# Disease Manifestation: T.brucei Delayed sensation to pain | Chronic Disease of Gambian or West African Sleeping

Kerandel’s sign

# Disease Manifestation: T.brucei Some would have Kernig sign | Gambian or West African Sleeping

Chronic Disease

# Disease Manifestation: T.brucei Terminal Phase: | Gambian or West African Sleeping

Coma leading to death

# Disease Manifestation: T.brucei appropriate specimen for diagnosis in chronic disease | Gambian or West African Sleeping

CSF

# Disease Manifestation: T.brucei Causes Rhodesian and East African Sleeping Sickness

Trypanosoma brucei rhodesiense

# Disease Manifestation: T.brucei Similar to Gambian Sleeping Sickness but _______ and ________ Sleeping Sickness | Rhodesian and East African

acute and rapidly progressing

# Disease Manifestation: T.brucei Less than ___ months, the patient will progress to sleeping sickness stage Sleeping Sickness | Rhodesian and East African

# Disease Manifestation: T.brucei ____ stage takes place in the early stages | Rhodesian and East African Sleeping Sickness

CNS

# Disease Manifestation: T.brucei Inflammation of the glomerulus Sleeping Sickness | Rhodesian and East African

Glomerulonephritis

Pathogenesis for T. brucei

- Generalized lymphoid hyperplasia - Anemia - Thrombocytopenia - Hypergammaglobulinemia - Immune Evasion - Acute infection - Chronic infection

# Pathogenesis: T. brucei Low hemoglobin and rbc count

Anemia

# T. brucei: Life Cycle Presence of it in the cerebrospinal fluid (CSF), would indicate the patient to be in _______

“Sleeping phase”

# Disease Manifestation: T.brucei Trypanosoma brucei gambiense causes

Gambian or West African Sleeping Sickness

# Pathogenesis: T. brucei Increase amounts of antibodies (IgM) in the blood and CSF

Hypergammaglobulinemia

# Pathogenesis: T. brucei Immune Evasion through :

Variant surface glycoproteins

Diagnosis: T.brucei

- Physical Findings and Patient HIstory - Demonstration of Trypomastigotes in Blood, CSF, Lymph Node Aspirate - Concentration of Buffy Coat - Serology - Molecular Methods - Animal Inoculation and Culture

# Diagnosis: T.brucei stain for Concentration of Buffy Coat

Giemsa Stain

# Diagnosis: T.brucei Serology:

IHAT, ELISA, Rapid Tests

# Pathogenesis: T. brucei Decrease in platelets

Thrombocytopenia

Clinical Findings: T.brucei

- In-vitro autoagglutination in blood - Elevated serum and CSF igM - Mott Cells in CSF

# Clinical Findings: T.brucei High IgM antibodies due to parasite producing __________

variable antigen types

# Gambian or Rhodesian No animal reservoirs | Reservoir host